Tuesday August 15th. The deep dark hole after Chemo

 

Kristina knew the post transplant period could be intense, but I suspect she was hoping to dodge the worst of the complications.  She texted that she didn’t know it would be this intense. 

Right now she’s still fighting the after effects of Chemo with ‘Mucositis’ being one of the primary things she’s dealing with.

Mucositis causes mouth sores and inflammation of the digestive tract.  The symptoms are painful and miserable.  The sores can become an entry point for infection, and it’s already caused her care team to feed her via an IV, getting nutrients into her bypassing both the mouth and the entire digestive tract.

As the side effect is common, there’s a common trajectory that it takes.  It starts, spreads, then creates ulceration and inflammation and finally the cycle ends with healing.  The care team tries to manage pain and keep Kristina fed while the painful cycle takes its course.

Added to the problem was a hard sneeze she had earlier last week with a bite to the tongue.  Without platelets, blood clotting doesn’t happen and, well, it got pretty gross pretty quick.

Then there’s the ‘Chemo brain’ that sets in – the foggy feeling where it’s difficult to concentrate. 

So other than not being able to think clearly, or talk, being fed through an IV, things are, well, about what you’d expect.  She says she’s going through that “deep dark hole of chemo, mucositis, and everything else that goes with it.”

Her care team is confident that cell recovery will begin to take place in the next few days – usually between day 12 and day 28.  She’s at day 14.  Earlier she had hoped that she’d start feeling a little better by today but by the sounds of it, that hasn’t happened. 

It’s too early for graft vs host disease (GVHD), as that may happen when cells start to multiply. 

“GVHD” is where the immune cells from the donor attack the host, Kristina in this case.  It’s not a sure thing she’ll have some version of it, but four out of five non related donor patients are impacted.  The very treatment that introduces life saving and rather magical stem cells also introduces a small army of immune cells who take it upon themselves to attack the very patient that the stem cells are trying to save.  I’m sure that there’s a more technical way of putting it, but with cancer, it seems that every treatment comes with significant side effects that need to be managed.

So that’s where we are today.  At her request there have been no visitors, and for now (unless you hear it from her directly), that holds.

Send prayers and positive energy.